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MelanomaPhase 1NCT02210104

Adoptive Therapy Using Antigen-Specific CD4 T-Cells

A Phase 1 study testing Ipilimumab, Cyclophosphamide and CD4+ T cells in people with Melanoma and Sarcoma, run by M.D. Anderson Cancer Center.

Withdrawn

Withdrawn. The study stopped before anyone enrolled.

Official record
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Trial summary

The goal of this clinical research study is to learn about the safety of giving CD4+T cells with ipilimumab and cyclophosphamide. CD4+T cells are a type of white blood cell. Researchers grow the T cells in the laboratory, and they are designed to find cancer cells and may kill them. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Melanoma, Sarcoma
What is being tested?
Ipilimumab, Cyclophosphamide and CD4+ T cells
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
0 participants
Where
No sites listed yet
Study dates
Dec 2016to Dec 2019
Phase
Phase 1
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Histopathologic documentation of melanoma, synovial sarcoma or mixed round cell liposarcoma concurrent with the diagnosis of metastatic disease.
  • Tumor expression of NY-ESO-1 (2+ staining or > 25%) by IHC.
  • Male or female subjects ≥18 years of age.
  • Expression of HLA-DPB1*0401
  • Eastern Cooperative Oncology Group (ECOG)/ Zubrod performance status of '0-1' .
  • Women of childbearing potential (WOCBP) must be using an adequate method of contraception to avoid pregnancy throughout the study in such a manner that the risk of pregnancy is minimized. Suggested precautions should be used to minimize the risk or pregnancy for at least 1 month before start of therapy, and while women are on study for up to 3 months after T cell infusion, and at least 8 weeks after the study drug is stopped. WOCBP include any female who has experienced menarche and who has not undergone successful surgical sterilization (hysterectomy, bilateral tubal ligation or bilateral oophorectomy) or is not postmenopausal
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  • Men must be willing and able to use an acceptable method of birth control, for at least 3 months after completion of the study, if their sexual partners are WOCBP.
  • Willing and able to give informed consent.
  • Adequate venous access - consider peripherally inserted central venous catheter (PICC) or central line
  • Bi-dimensionally measurable disease by palpation on clinical exam, or radiographic imaging (X-ray or CT scan)
  • At least 4 weeks must have elapsed since the last chemotherapy, immunotherapy, radiotherapy, or major surgery.
  • At least 6 weeks must have elapsed since the last nitrosoureas, mitomycin C and liposomal doxorubicin
  • Toxicity related to prior therapy must either have returned to < or equal to grade 1, baseline, or been deemed irreversible

Who cannot join

  • Patients with active infections or oral temperature > 38.2 C within 71 hours of Leukapheresis. The procedure may be deferred.
  • Patients with Hct <30%, white blood count (WBC) <2500/uL and platelets <50,000 immediately prior to Leukapheresis. The procedure may be deferred.
  • Any other malignancy from which the patient has been disease-free for less than 5 years, with the exception of adequately treated and cured basal or squamous cell skin cancer, superficial bladder cancer, carcinoma in situ of the cervix.
  • Complete blood count (CBC) and Chemistry profile prior to cyclophosphamide and T cell infusions: WBC < 2000/uL Hct < 24% or Hb < 8 g/dL absolute neutrophil count (ANC) < 1000 Platelets < 50,000 Creatinine > 3.0 x ULN AST/ALT > 2.5 x ULN Bilirubin > 3 x ULN
  • Pregnant women, nursing mothers, men or women of reproductive ability who are unwilling to use effective contraception. Women of childbearing potential with a positive pregnancy test within 3 days prior to entry.
  • Clinically significant pulmonary dysfunction, as determined by medical history and physical exam. Patients so identified will undergo pulmonary functions testing and those with FEV1 < 2.0 L or DLco (corr for Hgb) < 75% will be excluded.
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  • Significant cardiovascular abnormalities as defined by any one of the following: Congestive heart failure, Clinically significant hypotension, Symptoms of coronary artery disease, Presence of cardiac arrhythmias on EKG requiring drug therapy,Ejection fraction < 50 % (echocardiogram or MUGA).
  • Active and untreated central nervous system (CNS) metastasis (including metastasis identified during screening MRI or contrast CT).
  • Autoimmune disease: Patients with a history of Inflammatory Bowel Disease are excluded from this study, as are patients with a history of autoimmune disease (e.g. Systemic Lupus Erythematosus, vasculitis, infiltrating lung disease) whose possible progression during treatment would be considered by the Investigator to be unacceptable.
  • Any underlying medical or psychiatric condition, which in the opinion of the Investigator, will make the administration of study drug hazardous or obscure the interpretation of adverse events, such as a condition associated with frequent diarrhea.
  • Positive screening tests for HIV, Hep B, and Hep C. If positive results are not indicative of true active or chronic infection, the patient can be treated.
  • Steroids are not permitted 3 days prior to T cell infusion and concurrently during therapy.
  • Any non-oncology vaccine therapy used for the prevention of infectious disease within 1 month before or after any ipilimumab dose.
  • No prisoners or children will be enrolled on this study

About this study

Official title: Phase I Study of Cellular Adoptive Immunotherapy Using Autologous CD4+ NY-ESO-1-Specific T Cells and Anti-CTLA4 For Patients With NY-ESO-1-Expressing Tumors

The goal of this clinical research study is to learn about the safety of giving CD4+T cells with ipilimumab and cyclophosphamide.

CD4+T cells are a type of white blood cell. Researchers grow the T cells in the laboratory, and they are designed to find cancer cells and may kill them.

Read the detailed description

Study Groups:

If you are found to be eligible to take part in this study, you will be assigned to a study group based on when you join this study. The first 3 or 6 participants will receive a lower dose of ipilimumab. If there are no intolerable side effects, then the second group of 6 participants will receive a higher dose of ipilimumab.

All study participants will receive the same dose level of cyclophosphamide and the CD4+T cells.

Study Drug Administration:

You will receive cyclophosphamide by vein over about 30-60 minutes on Day -2 (2 days before you receive the CD4+T cells). If the doctor thinks it is needed, you will be given standard drugs to help decrease the risk of side effects. You may ask the study staff for information about how the drugs are given and their risks.

On Day 0, you will receive the CD4+T cells by vein over about 30-60 minutes. You will stay in the hospital overnight after the dose.

On Days 1, 22, 43, and 64, you will receive ipilimumab by vein over about 90 minutes.

Study Visits:

Within 2-4 weeks before you receive the CD4+T cells:

  • You will have a physical exam.
  • Blood (about 5½ tablespoons) will be drawn for routine tests, immune system tests, and tests on how long the T-cells survive in your body.
  • You will have a computed tomography (CT) scan or x-rays to check the status of the disease.

On Day -2:

  • You will have a physical exam.
  • Blood (about 1 tablespoon) will be drawn for routine tests. This routine blood draw will include a pregnancy test if you can become pregnant.

On Day 1:

  • You will have a physical exam.
  • Blood (about 1 tablespoon) will be drawn for routine tests.

On Days 0, 7, 14, 22, 28, 35, 43, 49, and 56:

  • You will have a physical exam.
  • Blood (about 5½ tablespoons) will be drawn for routine tests, immune system tests, and tests on how long the T-cells survive in your body.

On Day 3, blood (about 5½ tablespoons) will be drawn for routine tests, immune system tests, and tests on how long the T-cells survive in your body.

Between Day 35 and 42 and again between Day 77 and 84, you will have a CT scan or x-rays to check the status of the disease.

The study tests may be repeated or you may have additional tests performed anytime the doctor thinks it is needed.

Some of the study tests may be done at your local clinic if you cannot return to MD Anderson. The study staff will discuss this with you.

Length of Study Drug Dosing:

Your last study drug dose will be on Day 64. You will no longer be able to take the study drugs if the disease gets worse, if intolerable side effects occur, or if you are unable to follow study directions.

Your participation on the study will be over after the follow-up.

End-of-Study-Drug-Dosing Visit:

On Day 64:

  • You will have a physical exam.
  • Blood (about 5½ tablespoons) will be drawn for routine tests, immune system tests, and tests on how long the T-cells survive in your body.

Follow-Up:

On Days 70, 77, 84, 105, 126, 147, and 168:

  • You will have a physical exam.
  • Blood (about 5½ tablespoons) will be drawn for routine tests, immune system tests, and tests on how long the T-cells survive in your body.

Every 3 months after Day 84, unless the disease gets worse or you start another cancer therapy, you will have a CT scan or x-rays to check the status of the disease. Every 3 months for up to 5 years, the study staff will call you or ask your doctor how you are doing. If you are called, the calls should last about 10-15 minutes.

If the doctor thinks it is needed to confirm the status of the disease, blood (about 1½ tablespoons) will be drawn every 3 months for up to 1 year.

If the doctor thinks it is needed, you will return to the clinic every 4-6 weeks starting after Day 168 or as often as the doctor thinks is needed. These visits will stop if the T-cells disappear or if the disease gets worse. Blood (about 5½ tablespoons) will be drawn for routine tests, immune system tests, and tests on how long the T-cells survive in your body.

This is an investigational study. CD4+T cells are not FDA approved or commercially available. They are currently being used for research purposes only. Cyclophosphamide is FDA approved and commercially available for the way it is being used in this study. Ipilimumab is FDA approved and commercially available for the treatment of melanoma, but not for sarcoma. The study doctor can explain how the study drugs are designed to work.

Up to 12 participants will be enrolled in this study. All will take part at MD Anderson.

Conditions
Melanoma, Sarcoma
Being tested
Ipilimumab, Cyclophosphamide, CD4+ T cells
Keywords
Melanoma, Sarcoma, Mixed round cell liposarcoma, Advanced, Metastatic, Immunotherapy, Ipilimumab, Yervoy, BMS-734016, MDX010, Cyclophosphamide, Cytoxan, Neosar, CD4+T Cells
Medical subject headings
Melanoma, Sarcoma, Neoplasm Metastasis

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • IpilimumabDrug

    Also called Yervoy, BMS-734016, MDX010

    Starting Dose of Ipilimumab: 1.0 mg /kg by vein on Days 1, 22, 43, and 64.

  • CyclophosphamideDrug

    Also called Cytoxan, Neosar

    300 mg/m2 administered intravenously 2 days prior to T cell infusion.

  • CD4+ T cellsBiological

    Antigen-specific CD4+ T cells administered at a dose of 10^10 cells/m^2 on Day 0.

Study groups in NCT02210104
Study groupRoleWhat they receive
Ipilimumab + Cyclophosphamide + CD4+T CellsExperimentalStarting Dose of Ipilimumab 1.0 mg /kg by vein on Days 1, 22, 43, and 64. Cyclophosphamide 300 mg/m2 administered intravenously 2 days prior to T cell infusion as an outpatient procedure. Antigen-specific CD4+ T cells administered at a dose 10^10 cells/m^2.
Receives: Drug: Ipilimumab; Drug: Cyclophosphamide; Biological: CD4+ T cells

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Maximum Tolerated Dose (MTD) of Adoptively Transferred CD4 T Cells

    (MTD) defined as dose level below that at which excessive toxicity was observed. Dose limiting toxicity: Any ≥ Grade 2 eye pain or reduction of visual acuity that does not respond to topical therapy and does not improve to ≤ Grade 1 severity within 2 weeks of starting therapy requires systemic treatment; Any ≥ Grade 3 bronchospasm or other hypersensitivity reaction; Any adverse event, laboratory abnormality or intercurrent illness which, in the judgment of the Investigator, presents a substantial clinical risk to the patient with continued dosing; Any other ≥ Grade 3 non-skin related adverse event.

    Measured: 12 weeks after T cell infusion

Secondary outcomes (1)
  1. Clinical Response

    Complete response (CR) defined as total regression of all tumors, a partial response (PR) as 30% or greater decrease in the sum of the longest diameter of target lesions and progressive disease (PD) as 20% increase in the sum of the longest diameter of target lesions (modified world health organization criteria or mWHO. Radiographic imaging (as clinically indicated) and clinical assessment of residual disease compared with pre-infusion assessment.

    Measured: 6 weeks after T cell infusion

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted6 Aug 2014 (estimated)
  2. Study startDec 2016
  3. Primary completionDec 2019 (estimated)

Why it stopped: Issues with tetramer staining

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
0 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02210104
Sponsor's protocol ID
2013-0669
Other IDs
R01CA104711-09
Status last verified
Jul 2017
First submitted
4 Aug 2014
Last updated
21 Jul 2017
Results posted
No
Data monitoring committee
No

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing Ipilimumab, Cyclophosphamide and CD4+ T cells in people with Melanoma and Sarcoma, run by M.D. Anderson Cancer Center.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 13 inclusion and 14 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: withdrawn, as of the sponsor's last update on 21 Jul 2017. Status can change between updates, so confirm with the study contact before making plans.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study was withdrawn before enrolling participants, so there are no results.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Maximum Tolerated Dose (MTD) of Adoptively Transferred CD4 T Cells (time frame: 12 weeks after T cell infusion). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 21 Jul 2017.

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